Live Long and Prosper

Examining the Economic Value of Medical Research

Research by Kevin Murphy and Robert Topel

What value do Americans place on living longer and
healthier lives? Improvements in health and medical knowledge can greatly
affect the quality of life and the risks of mortality at various stages
of life. How much are people willing to pay for these improvements?

In a recent working paper entitled "The Economic
Value of Medical Research," economists Kevin Murphy and Robert Topel
of the University of Chicago Graduate School of Business conduct an
extensive study of the social, political, and economic issues surrounding
medical research in the United States. They find evidence that Americans
would enjoy enormous benefits from even modest progress in fighting
the major diseases, and their results make a strong case for increased
government funding for basic medical research.

A Measurable Difference

The authors begin by asking the broad question: How can we value improvements
in health and life expectancy? Armed with an economic framework for
addressing such issues, they estimate the economic value of the changes
in life expectancy observed over the past several decades. (Together
with other factors, the authors calculate "economic value" of medical
research by measuring how much a person would pay for an additional
year of disease-free life). Their analysis suggests that the historical
gains from increased life expectancy have been enormous, approximately
$2.8 trillion annually from 1970 to 1990. The reduction in death rates
from heart disease alone has increased the value of life by about $1.5
trillion per year over the 1970 to 1990 periodbenefits many times larger
than total spending on medical research over that period.

A further decline in death and illness from heart attacks, cancer,
and other diseases would produce additional benefits in the future,
they say. The authors estimate that eliminating deaths from heart disease
would generate about $48 trillion in economic value, and eliminating
deaths from cancer would be worth $47 trillion to Americans. In other
words, Americans would be willing to pay this amount to achieve such
an improvement in the length and quality of their lives.

While such dramatic improvements in health are not on the immediate
horizon, the authors' calculations suggest that reducing the death rate
from either heart disease or cancer by even 20 percent would generate
approximately $10 trillion in economic value to Americans, or more than
one year's worth of Gross Domestic Product.

Buying Time

The authors' estimates of the gains are so large in part because most
young men and women would be willing to pay a substantial amount even
for small reductions in their chances of dying from diseases such as
cancer, heart disease or stroke during middle or old age. Figure 1 estimates
that for a man in his 50s, the economic value of reduction in heart
disease is worth about $270,000. In other words, he would pay that amount
at that time in his life for an additional year of disease-free life.
The price is less for a younger man since the fear of disease is less
immediate.

In the case of AIDS-related diseases -- as opposed to heart disease
-- it is younger men (between ages 25 and 30) who would pay the highest
price for an extra year of life because AIDS most often affects younger
men. For women, a high value is placed on the reduction of death from
breast cancer.

Figure 1 illustrates the different values that men
place on an additional year of life without various diseases including
everything from heart attacks to cancer to AIDS to the flu. At younger
ages, people are less threatened by the thought of disease and so they
would pay lower amounts. In older age, there is a realization that additional
years are unlikely and their values decrease. In this example, it is
men in their mid-50s who would pay big money -- in the $250,000 range
-- for reduced death rates from heart attacks and cancer.

Room for Improvement

These results raise the question: Are we spending enough on medical
research? Of the $35.8 billion spent on medical research in 1995, $13.4
billion was funded by the federal government, more than $18 billion
came from private industry and about $4 billion was funded by other
private and public sources. Although the U.S. clearly invests in the
health of its population, other federal programs -- such as farm and
urban subsidies -- receive more sizeable attention. Government funding
for medical research accounted for about 21 percent of the overall federal
budget for research and development in 1995. The government allocates
only about $50 a person for medical research, compared with about $5,000
a person for all other federal programs. In the future, the amount of
additional spending on medical research by the government depends on
the difficulty of producing advances in medical knowledge. But the authors'
results suggest that the potential benefits of increased medical research
are so enormous, especially compared with the costs, that much higher
expenditures on research would be justified even if they only yield
small declines in death rates.

Until the Topel/Murphy study, little empirical evidence has existed
to prove the value of such basic medical research. The authors gathered
compelling evidence that economic gains from increasing life expectancy
were not only a past phenomenon but will continue to increase over time.
The extremely large value of improvements in health care for the country
as a whole follows directly from the fact that improvements in health
impact all segments of society and are complementary with all other
forms of consumption. For a rich country like the U.S., the value of
improving the health of its population is bound to be very large; as
the U.S. population grows, as lifetime income grows, as health levels
improve and as the baby-boom generation ages toward the primary ages
of disease-related death, the economic reward to improvements in health
will continue to increase. The authors estimate that the growth and
aging of the population alone will raise the economic return to improvements
in the treatments of many diseases by almost 50 percent between 1990
and 2030. In addition, projected increases in incomes and life expectancy
will add at least that much.

Policy Implications

Private companies have partly taken up the slack left by limited government
funding of medical research. However, these private companies naturally
pursue applied research -- vaccines, drugs and other products that can
be patented -- to earn a profit, rather than basic research such as
understanding the causes of cancer, which becomes free and common knowledge
once discovered.

Higher federal funding of basic research on a particular disease usually
increases rather than decreases spending by private companies because
a private company can capitalize on advances in knowledge created by
basic research of the disease. For this reason, the authors agree that
the government's main role in this area should be in supporting basic
research. They conclude that a doubling of annual government funding
would have only a small effect on the overall federal budget. Yet greatly
expanded basic research may have an enormous payoff by reducing deaths
from major diseases and by increasing the value, length and quality
of life for Americans.

Kevin
M. Murphy is the George Pratt Shultz Professor of Economics and
Industrial Relations at the University of Chicago Graduate School of
Business. Robert
H. Topel is the Isidore Brown and Gladys J. Brown Professor in Urban
and Labor Economics at the school.